A few weeks ago, my doctor concluded that I needed an MRI (magnetic resonance imaging) scan of my low back because he suspected injured disks between vertebrae.
I went off to Wilcox Medical Center as instructed and had the MRI. The outcome was disheartening. Two bulging disks and one herniated disk. Physical therapy is helping, but it was a reminder of my own fragility at age 71.
Then a couple of days ago, I got the bill for my share of the cost of the MRI from Hawaii Pacific Health. My health insurance is with HMSA. The bill indicated that Wilcox had billed for $1,785, but that the actual insurance payment was only $170. I owed a $100 co-pay. Total cost: $270.
This was an exercise in bulk purchasing. Because HMSA negotiates prices on behalf of tens of thousands of people, the payment Wilcox got was in full, based on the amount of business HMSA sends to the hospital. But if I had been an uninsured person, I’d have been on the hook for a clearly unaffordable fee.
HMSA’s negotiated price represents the power of insurance, in which everyone — healthy or not — helps share the cost of everyone else’s health care. It’s protection against catastrophic debts when you are very sick or badly injured. The car insurance you are required to have works the same way, for the same reasons.
This lesson is important, right now, today. In Washington, as regards the tax-cut package being considered by the U.S. Senate. Republicans in the Senate added a provision to the tax-cut bill — which in and of itself is, essentially, a give-away to the super-rich — that would eliminate a requirement in the Affordable Care Act that requires most people to have health insurance.
That way, people who are OK right this minute are absorbing the costs of those who aren’t with the understanding that when today’s healthy people inevitably need care, it will be covered and they will not be forced into bankruptcy.
The Affordable Care Act (sometimes known as “Obamacare”) is an imperfect system that needs some revision and adequate funding to make it work. Even then, it’s only an interim system until we as a country can get to universal insurance through a single government payment agency.
Republicans want to repeal the mandate that all people carry insurance. Their argument is that healthy young people should not be forced to pay for the health care of sick old people. Not only does this position conflict with the fundamental premise of carrying any insurance, it disrespects the aloha spirit of caring for kupuna when they need it.
The Hawaii delegation to Congress — two representatives and two senators — is not the problem. All four of them oppose this legislation. The battle is going to be fought, within the next few days, in the Senate. The forces of logic that support keeping the ACA afloat and understand why the insurance requirement makes sense need to capture at least three votes of Republican senators from other states since the Senate right now is split 48-52 Democratic versus Republican. A simple majority would determine who wins.
Raising your voice with either of our senators is preaching to the choir. It is Republicans in the leadership, starting with Sen. Mitch McConnell, who need to be forced to realize that what they propose will throw millions of people off health insurance and do lasting damage to the economy and our social fabric.
Calling, emailing or writing to members of Congress and the Senate may seem like a cliché and a doomed approach. It isn’t.
The rest of the tax legislation, beyond the repeal of mandatory health insurance that will injure millions, is equally onerous. The House of Representatives has already passed a very bad bill. The Senate is considering an even worse one.
But that fight will have to wait a few days. What will count in the next 72 hours or so is the amount of pressure brought to bear on the Senate to preserve the minimal protection provided by the Affordable Care Act.
Your voice can be heard.
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Allan Parachini is a former journalist and PR executive. He is a Kilauea resident.
Aloha Allan, you make a good point, here is a counter point.
$4 Trillion a year is spent on disease care, like your “bad back”.
All that $4 Trillion dollars a year goes to the Big 4 of Disease Care: Doctors, Hospitals, Phamaceutical Companies, and Insurance Companies.
Regardless if your disease outcome remains the same, improves or gets worse, the Big 4 get the whole $4 Trillion. Guaranteed large wages. Whether it is Obama Care or Trump Care the Big 4 get the whole $4 Trillion for our nation’s Disease Care regardless if our nation’s disease statistics get worse year after year, which in fact they do. More heart and vascular disease, diabetes, and cancers are reported every year.
America is ranked #1 in the world for “health care” costs and #37 in quality of health care, we are after tiny postage stamp sized Costa Rica.
Americans have an Illusion of Invincibility when it comes to Disease Care. Current mind set for the majority of AMERICANS is do nothing about your health, wait for disease to come like a mystery and march off to the hospitals and doctors who WILL BE WAITING FOR YOU…!
Not counting over-the-counter medication or illegal drugs, 70% of AMERICANS take prescription drugs. We are a drug dependency nation.
That makes America a weak nation…! ! ! Regardless of the motto “Make America Strong Again”, as a nation of people and families we are doing nothing about that, the individual strength of our people lives at the “pill mill”.
There is an alternative, it’s called Actual Health Care. It starts with yourself.
As to so many of the Chronic Degenerative Diseases, like Heart and Vascular disease, and the increasing types of cancers, as well as the illnesses and deaths caused by doctors prescribing drugs that TV ads admit to their drug toxicity and lethality; why does the general public and government agencies continue year after decade to entrust those who profit from selling TREATMENTS, to bother themselves with Providing the public with the EDUCATION and KNOWN INFORMATION that has proven to prevent much of the $4 Trillion dollars a year spent on doctors, hospitals, petrochemical-pharmaceutical companies, and insurance companies; resulting in no real health benefit to the public on our return on the $4 Trillion investment except for the yearly worsening disease statistics.
Blind Faith in Disease Care has reached bankruptcy on the public, individual, and family health.
An ounce of Prevention is worth a Ton of Cure.
Disease Prevention is best served by Education starting in kindergarten and progressing in depth through high school graduation at which point every student will know more about their own body and its needs than any doctor.
Knowledge of our bodies, and of food and chemicals and poisons, prevents disease and prevents the need for treatments and their nasty chemical and surgical side effects.
The definition of STUPID is: You can’t expect to EAT the same things over and over and expect a different result with disease. Both Health and Disease come from eating, but how would you know what to eat without an education leading to the iIntelligent choice of food.
Is there someone who could step up to the Dept. Of Education and make a change? Are there ethical doctors and dentists out there willing to trade in their after-the-fact Treatments for teaching Preventative Disease Education? Health Education prevents disease.
You should Know well that the word PHYSICIAN means TEACHER…!
Where have all the Physicians gone?
Best to your Health, remember, it’s a Personal issue.
It starts with 4 big words that are fun, interesting, and easy to learn about: Anatomy, Physiology, Histology, and BioChemistry; more than science they are actually: YOU…!
Learn about the real you, prevent disease, and don’t take drugs of any kind; drugs and medicine are chemicals, they all have ill side effects.
Health is a personal responsibility; your knowledge is your Health Care. Health Care prevents Disease Care.
Don’t Wait…EDUCATE…! ! !
Allan, Allan, Allan,……never bring yourself in to an argument.
“It disrespects the aloha spirit of caring for kupuna when they need it.” Ok, EVERYONE pays for Medicare. You know, that health insurance you get when you turn 65……EVERYONE gets it.
The plan to eliminate the requirement to have health insurance, ah,……wait for it………Is not “essentially, a give-away to the super-rich”, RATHER, it is so the US Government does not have to subsidize those that cannot afford to actually pay for their health insurance.
In the world of unicorns and rainbows, “free” is a great thing. In the real world, where health insurance costs $$$$$$, it is a zero-sum game. You want “free healthcare”, then $$$$$ are coming out of affordable housing, less government services, US Defense Budget (which is a REQUIREMENT in the US Constitution, not Universal Healthcare).
75% of Americans are obese or overweight, few exercise for better health, anyone can smoke cancer causing cigarettes, we have endless drug addicts and alcohol addiction in this country. All of this is by choice. So yea, I want to fund all these people with FREE HEALTHCARE for their poor choices.
Healthcare in the US is not perfect, but it should be a choice. The best healthcare on the planet is in the US because there is competition. The Government in Healthcare? Any government employee is just punching the clock for 40 hours a week with no sense of urgency on anything. Yea, I want those people doing my Healthcare.
Nothing more depressing than reading something from Jake who, from his lofty perch, describes the technical details as to how people who have never met and adored him are to be told “Tough toenails, brah, if you don’t have the dough, technically we don’t have to help you live; it’s all here on this piece of paper I’m holding!”
Charlie, the unfortunate truth about your appeal for leaving the corruption of establishment medicine for the soft and gentle graces of alternative medicine is that Alt Med is the comfortable nesting ground of quackery and many times more corrupt! Where do you think those who lose their license to practice go? They don’t take up basket weaving or hotel hospitality. There is no regulation or accountability overseeing that “health food store” you frequent. You think that little $87 vial actually contains essential oil of Tibetan goose down? Why would they bother? Who is gonna know? If treatment isn’t evidence based, why would you choose it? “Well, it worked for the late Charlie’s Aunt Mable, too bad it didn’t work for him; NEXT!”